摘要
"新常态"下经济下行与财政压力的加剧,势必对新医改沿用增量改革方案的可持续性形成严峻的挑战:在需求侧,虽然医保覆盖率和保障标准的提升带来医疗投入的不断增加,但"看病贵"问题因居民卫生支出的高速增长并未得到有效化解,同时地方医保基金"穿底"风险开始凸显;在供给侧,公立医院补偿机制改革虽然在一定程度上破解了"以药养医"的问题,但引发了医院通过"医疗诱导性消费"进行"以医补药"的新问题,大型公立医院继续垄断优质医疗人才、呈现趋利性,"看病难"问题在城乡均没有得到根本缓解。新医改在"十三五"期间的推进,必须从微观入手,聚焦供给侧最核心的资源,实现医生的有效激励与合理流动,通过打破公立医院对存量医疗资源的垄断来获得动力。具体而言,应设立国家层面的健康委员会,创新医生就业体制,逐步建立更加合理的医疗服务定价机制。
The economic downturn alongside its increased financial pressure on the government is seriously challenging the sustain- ability of China＇s New Health Reform that dwells on a marginal reform approach. In the demand end, soaring government spending to expand health insurance＇s coverage and to enhance its standards is offset by abrupt increase in citizens＇ medical expenditure. Medical treatment remains expensive while local governments＇ health insurance systems are bankrupting. In the supply end, compensations to public hospitals have curtailed profits from medicine, but induced overconsumption of other medical services. Mega public hospitals re- main for-profit and overcrowded. Accordingly, incoming reform must shift to storage reallocation. Namely, New Health Reform should terminate the administrative monopoly of high-quality doctors in public hospitals, which will promote the dynamics of medical resource exchange and establish a more effective price mechanism. In specific, a national health committee must be organized to steer the reform, doctors need to be liberated from their administrative identity, and the price of medical services requires deliberation, not discre- tion.
出处
《中州学刊》
CSSCI
北大核心
2016年第8期56-61,共6页
Academic Journal of Zhongzhou
基金
国家社会科学基金重大项目"我国社会公平正义状况测度与改善对策"(12&ZD060)
吉林省社会科学基金项目"国家治理体系与治理能力现代化的微观基础"(2014B11)
关键词
新医改
增量改革
存量改革
公立医院
多点执业
the new health reform
incremental reform
storage reform
public hospitals
muhi-location licensing
